Donelan Jill, Douglas Susan, Willson Ariane, Lester Tyrena, Daly Stephanie
Department of Psychiatry Baystate Health, Springfield, MA, USA.
Mirah, Boston, MA, USA.
Adm Policy Ment Health. 2025 Jan;52(1):128-145. doi: 10.1007/s10488-024-01358-2. Epub 2024 Apr 4.
This paper describes the successful implementation of Measurement-Based Care (MBC) within a Partial Hospitalization Program (PHP) for children and adolescents. Measurement-based care (MBC), the practice of using patient-reported measures routinely to inform decision-making, is associated with improved clinical outcomes for behavioral health patients (Jong et al., Clinical Psychology Review 85, 2021; Fortney & Sladek, 2015). MBC holds great promise in partial hospital programs (PHP) to improve outcomes, yet implementation strategies are as complex as the setting itself. This paper provides a case study example of MBC implementation in a PHP for youth. Over the course of 18 months, an interdisciplinary staff of approximately 20 behavioral health professionals provided partial hospitalization level of care to 633 (39% in-person, 61% telehealth) youth from ages 5 to 18 years old. MBC in this setting incorporated daily patient self-report and weekly caregiver-reported measurements. This descriptive reconstruction, which includes examples of the data that were used during the implementation project, illustrates specific barriers and facilitators in a successful implementation in the local PHP setting. Implementation strategies to address workflow integration, leadership and supervision, and coaching are described, including evolution of these strategies over the course of implementation. Practical considerations for implementing MBC in youth PHP settings are discussed. Finally, the authors explore the potential relationships between the data-driven MBC model of decision making and the development of resilient organizations.
本文描述了在儿童和青少年部分住院治疗项目（PHP）中成功实施基于测量的护理（MBC）的情况。基于测量的护理（MBC），即常规使用患者报告的测量方法来为决策提供信息的实践，与改善行为健康患者的临床结果相关（Jong等人，《临床心理学评论》85，2021；Fortney & Sladek，2015）。MBC在部分住院治疗项目（PHP）中对于改善结果具有很大潜力，但其实施策略与该环境本身一样复杂。本文提供了一个在青少年PHP中实施MBC的案例研究示例。在18个月的时间里，一支由大约20名行为健康专业人员组成的跨学科团队为633名年龄在5至18岁的青少年提供了部分住院治疗水平的护理（39%为面对面治疗，61%为远程医疗）。在这种情况下，MBC纳入了每日患者自我报告和每周照顾者报告的测量。这种描述性重建，包括实施项目期间使用的数据示例，说明了在当地PHP环境中成功实施的具体障碍和促进因素。描述了用于解决工作流程整合、领导与监督以及指导的实施策略，包括这些策略在实施过程中的演变。讨论了在青少年PHP环境中实施MBC的实际考虑因素。最后，作者探讨了数据驱动的MBC决策模型与有复原力组织的发展之间的潜在关系。
